• Childhood Kidney Diseases
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• v.10 no.2
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• pp.219-227
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• 2006

Purpose : We aim to identify the clinical and demographic characteristics in children who underwent renal transplantation(RTx) and to evaluate the influence on growth of RTx in children. Methods : We reviewed 17 medical records of chronic renal failure patients who underwent RTx from April 1992 and June 2004 at Busan Paik Hospital. Age and sex distribution, cause of disease, donor analysis, patient and graft survival rate, and the status of growth after RTx were analysed by retrospective study. Results : Eighteen RTx were performed in 17 patients(8 boys, 9 girls). The mean age at the time of RTx was $15.8{\pm}3.5$ years and the mean duration of dialysis therapy before RTx was $22.4{\pm}18.0$ months. The 1 year and 5 year patient survival rate were each 100%, and the 1 year and 5 year graft survival rate were 88%, 36% respectively. The most common cause of graft failure was chronic rejection. The mean final height of male patients was $162.8{\pm}10.0$ cm(143.0-172.5 cm) and of female patients was $154.5{\pm}12.1$ cm(135.8-160.0 cm). The mean height standard deviation score(Ht SDS) increased after RTx from -1.95 to -1.53 but the increment rate was not statistically significant. Similar changes were noted in individual patient analysis. Also there was no significant difference between the living-related donors and cadaveric donors. Conclusion : Our data shows that even successful RTx rarely results in full growth rehabilitation. To overcome retarded growth in children with chronic renal failure, appropriate combined management of metabolic and nutritional problems, correction of anemia, proper use of recombinant growth hormone therapy, early renal transplantation and shortening of the duration of dialysis would be necessary.

• Childhood Kidney Diseases
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• v.13 no.2
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• pp.197-206
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• 2009

Purpose : Limited information is available on experiences of intravenous iron treatment in children. In this study, iron sucrose was administered intravenously to determine its effect, the factors predicting outcome, and safety in children on chronic dialysis. Methods : Twenty-one children whose serum ferritin levels were less than 100 ng/mL or transferrin saturations (TSAT) were less than 20% were enrolled. In 12 children on peritoneal dialysis (PD), the drug was infused intravenously as 200 mg/$m^2$ ($\leq$200 mg) at week 0, 2, 4, and 6. In 9 children on hemodialysis (HD), it was given intravenously as 8 weekly doses of 3 mg/kg ($\leq$100 mg) through week 0-7. Results : After treatment, serum ferritin levels increased significantly in both groups, and TSAT rose significantly in PD group. However, hemoglobin level did not rise significantly in both groups. Children with baseline hemoglobin less than 10 g/dL or baseline TSAT less than 20% showed significantly higher rise of hemoglobin after intravenous iron treatment. To the contrary, those with higher baseline hemoglobin and TSAT levels displayed higher rise in serum ferritin after the treatment. Although no serious adverse event occurred, TSAT levels exceeding 50% were noted in 6 patients in PD group. Conclusion : This suggests that 3 mg/kg/week of intravenous iron sucrose can be used safely in children on chronic HD, but 200 mg/$m^2$ every other week may incur excessive TSAT level in some patients on chronic PD.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.1
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• pp.16-22
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• 2017

Objectives: Bisphosphonate is the primary cause of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Bisphosphonates are eliminated from the human body by the kidneys. It is anticipated that bisphosphonate levels in the body will increase if the kidney is in a weak state or if there is systemic disease that affects kidney function. The aim of this study was to analyze the relevance of renal function in the severity of BRONJ. Materials and Methods: Ninety-three patients diagnosed with BRONJ in Pusan National University Dental Hospital from January 2012 to December 2014 were included in this study. All patients underwent a clinical exam, radiographs, and serologic lab test, including urine analysis. The patient's medical history was also taken, including the type of bisphosphonate drug, the duration of administration and drug holiday, route of administration, and other systemic diseases. In accordance with the guidelines of the 2009 position paper of American Association of Oral and Maxillofacial Surgeons, the BRONJ stage was divided into 4 groups, from stage 0 to 3, according to the severity of disease. IBM SPSS Statistics version 21.0 (IBM Co., USA) was used to perform regression analysis with a 0.05% significance level. Results: BRONJ stage and renal factor (estimated glomerular filtration rate) showed a moderate statistically significant correlation. In the group with higher BRONJ stage, the creatinine level was higher, but the increase was not statistically significant. Other factors showed no significant correlation with BRONJ stage. There was a high statistically significant correlation between BRONJ stage and 'responder group' and 'non-responder group,' but there was no significant difference with the 'worsened group.' In addition, the age of the patients was a relative factor with BRONJ stage. Conclusion: With older age and lower renal function, BRONJ is more severe, and there may be a decrease in patient response to treatment.

• Korean Journal of Food Science and Technology
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• v.31 no.4
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• pp.1101-1108
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• 1999

Soybean (SoyPep) was prepared and evaluated their action on blood lipid profiles, select biochemical indexes and histopathological changes in spontaneously hypertensive rat (SHR). Male SHRs were divided into three groups and fed the experimental diet containing 0% (control), 3%, 10% SoyPep for 8 weeks. Lipids, antioxidative vitamin levels, glutamate oxaloacetate transaminase (GOT) and glutamate pyruvate transaminase (GPT) activities in plasma were measured, and angiotensin I converting enzyme (ACE) activities in kidney, vascular tissue and plasma were also measured. In addition, histopathological changes in various organs were investigated. Dietary SoyPep was effective for lowering plasma levels of triglyceride and LDL-cholesterol. ACE activities in aorta and kidney were decreased in the group fed SoyPep compared to control. There was no difference of plasma GOT and GPT activities, and no histopathological difference in various organs among the experimental groups. Our results suggest that SoyPep has beneficial effects on diseases such as hypertension and atherosclerosis. SoyPep could be useful to develop a novel functional safe food additive for preventing the chronic diseases.

• Korean Public Health Research
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• v.44 no.4
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• pp.35-49
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• 2018

Objective : The purpose of this study was to investigate the risk factors of dehydration from the subjects who underwent anthropometric and blood parameters testing during a comprehensive health screening. Methods : For the study analysis, 5,391 samples with valid data of the levels of Sodium($Na^+$), BUN (Blood Urea Nitrogen) and FBS(Fasting Blood Sugar) were selected to calculate a dehydration indicator of plasma osmolality. The study data was collected from the health screening examinees who visited Sahmyook Medical Center Seoul Adventist Hospital Comprehensive Health Check-up Center from 2014.01.01 to 2015.12.31. The relationship between dehydration and age group, BMI, disease exposures(hypertension, diabetes mellitus, dyslipidemia, kidney disorder) were analyzed by gender. Results : The odds ratio of dehydration showed statistical significance from age ${\geq}50$ in both male and female, respectively. The female obese group was vulnerable to dehydration while the male study group showed no statistical significance in the BMI difference. The disease exposed groups(hypertension, diabetes mellitus, dyslipidemia, kidney disorder) were vulnerable to dehydration. Also, the more types of disease carried by the exposed patients, the higher odds ratio and susceptibility to dehydration. Conclusions : Aging, increasing BMI, and exposed to diseases were found to be the risk factors for vulnerability to dehydration. To prevent dehydration, special caution to be taken for those in the ${\geq}50s$ group, along with controlling BMI and chronic diseases. Further studies are suggested to investigate the risk factors of dehydration that may affect increasing plasma osmolality as a potential stimulus mechanism in disease outbreaks.

• Childhood Kidney Diseases
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• v.5 no.2
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• pp.78-86
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• 2001

Purpose: Rapidly progressive glomerulonephritis (RPGN) is characterized by the rapid increase in serum creatitnin and crescents formation involving more than $50\%$ of glomeruli. 10 patients who had been treated for RPGN were studied retrospectively for thier underlying diseases and clinical features Method: Cilinical review was performed on 10 children who were diagnosed with RPGN by clinical features and renal biopsy and followed up at department of pediatrics during tile last 10 years, from May 1990 to May 2000. Result: There were 6 males and 4 females between the ages of 2.1 and 14.3 years (mean $10.9{\pm}3.8$). 3 had Henoch-$Sch{\ddot{o}}nlein$ purpura nephritis; 2, idiopathic rapidly progressive glomerulonephritis; 2, lupus nephritis; 1, hemolytic uremic syndrome; 1, membranous glomerulonephritis and 1, microscopic polyangiitis. The most common chief complaints were gross hematuria and oliguria. Initial clinical features included proteinuria, edema, hypertension, nausea and arthralgia. Mean serum BUN was $74.2{\pm}39.1\;mg/dL$ mean serum creatinin, $3.2{\pm}1.8\;mg/dL$ and mean creatinin clearance, $26.5{\pm}13.2\;mL/min/1.73m^2$. Antineutrophil cytoplasmic antibody was positive only in microscopic polyangiitis. ANA and Anti-DNA antibody were positive in two lupus nephritis patients. Serum complements were decreased in 4 patients. All patients except Hemolytic uremic syndrome received steroid pulse therapy and immunosupressive agents. 3 patients were performed acute peritoneal dialysis and 2 patients were given plasmapheresis. At the last follow up, 1 patient was dead, 4 patients had elevated serum creatinin, 2 of these 4 patients were on chronic ambulatory peritoneal dialysis and 6 patients had normal renal function. Conclusion: Rapidly progressive glomerulonephritis is a medical emergency that requires very rapid diagnosis, classification, and therapy. Appropriate therapy selected on the basis of underlying disease mechanism can substantially improve renal survival. (J. Korean Soc Pediatr Nephrol 2001 ; 5 : 78-86)

• Childhood Kidney Diseases
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• v.14 no.1
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• pp.42-50
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• 2010

Purpose : The clinical characteristics and associated anomalies in children with solitary kidney (SK) were analyzed retrospectively. Methods : Total 38 children diagnosed to have SK at our hospital between December 1989 and December 2009 were recruited, and the clinical records including imaging studies were retrospectively reviewed. SK was defined as unilateral renal agenesis by imaging studies only, and patients with regression of unilateral dysplastic kidney were excluded. Results : Among total 38 patients, 12 were male. The median age at the diagnosis of SK was 6.5 months (at birth-13 years). SK was detected by prenatal ultrasonography in 14 patients and during work-up for renal or urinary tract diseases in 13 (including urinary tract infection in 7). In 10 patients, SK was detected incidentally. Anomalies in the SK were noted in 17 patients including vesicoureteral reflux in 11. Other anomalies in the genitourinary tract were present in 16 patients, and multi-organ-involving syndromes or chromosomal anomalies were detected in 9. The mean duration of follow-up was 9 years (9 months-20 years). Two patients developed chronic renal failure during follow-up, and the median serum creatinine concentration of the remaining 36 at their last follow-up was 0.6 mg/dL. Conclusion : SK may be isolated and clinically asymptomatic; it is frequently accompanied by other anomalies in genitourinary tract and other organs, some of which can induce progressive renal dysfunction. Early recognition of associated anomalies with SK and regular follow-up is recommended to reduce long-term risk.

• The Korean Journal of Nuclear Medicine
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• v.25 no.2
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• pp.227-236
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• 1991

Background: The evaluation of individual renal function is important to diagnosis and follow-up of various diseases. Ureteral catheterization of each kidney has been widely used for this purpose, but this method had some technical difficulty, frequent complications and much restriction in reapplication. Therefore we tried to applicate radiopharmaceuticals for the evaluation of individual renal function. Methods: We measured 2 hour, 4 hour and 24 hour relative renal uptake of $^{99m}Tc-DMSA$ and relative glomerular filteration rate of $^{99m}Tc-DTPA$ with 59 patients with various renal diseases to determine their usefulness for assessment of individual renal function and to compare correlations between every renal uptake of $^{99m}Tc-DMSA$ and relative glomerular filteration rate. Results: The correlations between 2 hour-, 4 hour- and 24 hour- relative renal uptake of $^{99m}Tc-DMSA$ and relative glomerular filteration rate of $^{99m}Tc-DTPA$ were R=0.9190 (p < 0.001), R: 0.9229 (p<0.001) and R=0.9917 (p<0.001). In acute obstructive uropathy, the correlations at 2 hour and 4 houre were poor as R=0.1812 (p<0.05) and R=0.4923 (p < 0.05), but the correlation at 24 hour was good as R=0.9942 (p<0.001). Conclusions: We concluded that relative renal uptake at 2 hour and 4 hour had good correlation with relative DTPA uptake ratio in the cases without chronic renal failure and obstructive uropathy. Delayed image with 24 hour relative renal uptake $^{99m}Tc-DTPA$ had the best correlation with relative glomerular filteration rate of $^{99m}Tc-DTPA$ and that might be useful in evaluation of chronic renal disease in which showed increased beckground activity or acute obstructive uropathy.

• Journal of Chest Surgery
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• v.50 no.2
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• pp.86-93
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• 2017

Background: The influence of lifestyle diseases on postoperative complications and long-term survival in patients with non-small cell lung cancer (NSCLC) is unclear. The aim of this study was to determine whether lifestyle diseases were significant risk factors of perioperative and long-term surgical outcomes in elderly patients with stage I NSCLC. Methods: Between December 1995 and November 2013, 110 patients aged 65 years or older who underwent surgical resection of stage I NSCLC at Dong-A University Hospital were retrospectively studied. We assessed the presence of the following lifestyle diseases as risk factors for postoperative complications and long-term mortality: diabetes, hypertension, chronic obstructive pulmonary disease, stroke, and ischemic heart disease. Results: The mean age of the patients was 71 years (range, 65 to 82 years). Forty-six patients (41.8%) had hypertension, making it the most common lifestyle disease, followed by diabetes (n=23, 20.9%). The in-hospital mortality rate was 0.9% (n=1). The 3-year and 5-year survival rates were 78% and 64%, respectively. Postoperative complications developed in 32 patients (29.1%), including 7 (6.4%) with prolonged air leakage, 6 (5.5%) with atrial fibrillation, 5 (4.5%) with delirium and atelectasis, and 3 (2.7%) with acute kidney injury and pneumonia. Univariate and multivariate analyses showed that the presence of a lifestyle disease was the only independent risk factor for postoperative complications. In survival analysis, univariate analysis showed that age, smoking, body mass index, extent of resection, and pathologic stage were associated with impaired survival. Multivariate analysis revealed that resection type (hazard ratio [HR], 2.20; 95% confidence interval [CI], 1.08 to 4.49; p=0.030) and pathologic stage (HR, 1.89; 95% CI, 1.02 to 3.49; p=0.043) had independent adverse impacts on survival. Conclusion: This study demonstrated that the presence of a lifestyle disease was a significant prognostic factor for postoperative complications, but not of survival, in elderly patients with stage I NSCLC. Therefore, postoperative complications may be influenced by the presence of a lifestyle disease.

• Journal of Nutrition and Health
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• v.57 no.5
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• pp.481-495
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• 2024

Purpose: Malnutrition is a prevalent condition leading to a high risk of morbidity and mortality in hemodialysis patients. This study examined the malnutrition risk and the influence of diabetes on clinical characteristics, nutritional knowledge, and dietary intake in chronic kidney disease (CKD) patients on hemodialysis. Methods: Seventy-six patients (37 with diabetes and 39 without diabetes) enrolled in an internal medicine hemodialysis unit in Seoul were examined. A questionnaire, anthropometric, biochemical, and three-day dietary record data were collected. The nutritional risk was screened by the Patient-Generated Subjective Global Assessment (PG-SGA), compared to the Global Leadership Initiative on Malnutrition (GLIM). Results: The overall prevalence of malnutrition was 56.6% and 27.6% by PG-SGA and GLIM, respectively, showing the low sensitivity (34.9%) and agreement (kappa = 0.16) of GLIM compared to the PG-SGA. CKD patients with diabetes had a higher malnutrition risk and more comorbidities than those without diabetes (p < 0.05). More than 60% of patients had anemia and hypocholesterolemia. Despite the fair level of nutritional knowledge, the intakes of energy per ideal body weight, calcium, vitamin A, vitamin B₆, folate, and vitamin C were below the nutritional guidelines for hemodialysis patients in more than 70% of the patients. When stratified according to sex, female patients showed marked differences, with lower energy, protein, fat, calcium, phosphorus, vitamin B₂, folate, and vitamin B₁₂ intakes in diabetic patients compared to non-diabetic patients. The most challenging aspect of diet therapy for hemodialysis patients was achieving the appropriate protein intake for diabetic patients and restricting phosphorus intake for non-diabetic patients (p < 0.05). Conclusion: These findings suggest that attention should be paid to the malnutrition of diabetic hemodialysis patients. Individualized nutritional counseling and management are needed for the nutritional care of hemodialysis patients to address the nutritional deficiency.